You have been diagnosed wit sleep apnea for the most part you are dependent on your doctor, lab technicians, the equipment company and your insurance for which machine you will have the ability to get.  But if you know what machines are on the market and what they offer you can choose a machine that will help you while keeping your needs in mind

The first think you need to consider is cost.  What really is the issue is not so much the cost of the machine, because they all run about the same price, but what you are willing to pay for and what you are willing to accept if you have insurance.  Insurance companies have different ways of paying for durable medical equipment.  Some treat as a regular part of insurance.  So if you have a deductible of $500 and then they pay 80% for care once that deductible is reached then you know what your expense will be.  This is not all insurances.  You may have an insurance hat has a durable medical equipment rider.  In this case it will have its own deductible that you will have to meet and then it will pay a percentage after it is met.  The third type of program is an HMO program.  Usually they have a specific copay of $50-$100.  They also require the use of a specific durable medical equipment company and will limit what equipment can be used including machines, masks and if you get a home visit or if you receive the machine from a UPS box.    If you are paying cash then you will have the most say over what type of machine you will receive.  However if you have a big deductible and know it you might get a better deal paying cash and submitting the claim yourself then you would using your insurance.

Once you have determines what you are willing to spend and what your insurance will cover then next decision is to figure out what is the most important aspects of the machine for you.  If you travel a lot it might be the size of the machine.  If you like to camp it might be that you want a back up battery.  If you know you have a great deal of problems with nasal congestion in might be a machine with the best humidification system.   Whatever issues you face it is important to know them up front so when you are working with the therapist who is setting up you new machine they know what is important to you.

The other issue is something that many patients are not aware of but is vital to getting insurance to pay for the machine.  Many insurances including Medicare require documented compliance of the use of the equipment.  This is usually done one of three ways.  A person comes to your house reads the hours of use on the machine.  The second way is that the machine has a card that you either plug into your computer and download and send to the DME company or your physician.  The third, and newest way, is that your machine will have a modem that will allow the DME company and your physician to follow you use remotely.  The remote compliance also allows changes to your machine without someone having to come to your house.  

Now that you know about what factors are involved with choosing a machine let discuss what some of the machines on the market have to offer.  

As far as size on the average the newer machines weight between 2.5 and 3 pounds and are quite small.  They have built in humidification systems, although some are better then others.  The newest machines are also more aesthetically pleasing.  Resmed’s new machine the S9 has a sleep look and resembles a book shape sitting on the night stand.  Most of the other machines are either shaped as a cube or shaped like and alarm clock.  They all have a hose and a mask to attach the machine to the patient. If however you plan to travel the Everest has the ability for you to purchase a rechargable battery that fits over the bottom of the machine.  This allows for a stacked cube shape that is still faily light weight.

The cost can be a big consideration for a person especially if they have a high deductible or no insurance.  Some of the basic machines like the Everest, the Tango and some of the older models do not have as many of the newer comfort measures but they do allow for good basic therapy at an affordable price.  For those with no insurance and limited income many of the DME companies work with the manufacturers to get discounts of no cost machines based on income. 

If you have trouble with drying during the night then one of the machines with a heated wire tubing system such as the Resmed S9 or the Fisher Paykel machines will pprobably be your best choice.  Fisher Paykel is the leader in this technology having initially created it to help with ventilation of neonatal patients who were being ventilated. 

If you wish  for the newest, quietest machines with the most comfortable software so that the machines allows the pressure to work with you both the Respironics  PR series and the Resmed S series of machines have been upgrades to be the quietest on the market.  They have also created software for their machines that will work to make these machines more like natural breathing then breathing on a machine.  Both of these machines also have th eability to have a modem added for closer following of compliance and for changing of pressures without having to go visit the patient’s house. 

When choosing a CPAP machine you should always listen to you physician but with a little education you might be able to avoid some of the problems that many new patients have.  Decide for yourself what issues are most important to be met and then discuss your options with a professional.  Look at these machines and try them out at your local DME company before you make a final decision. 


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